Individual
MELODY BETH STAUFFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1122 HEALTHCARE DR, MOUNT CARROLL, IL 61053-1461
(815) 244-1376
Mailing address
PO BOX 284, CHADWICK, IL 61014-0284
(815) 622-8052
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YP2500X
Professional Counselor
180011679
IL
Other
Enumeration date
08/15/2012
Last updated
02/02/2022
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